2007 - 2008 Texas Influenza Surveillance Information

Influenza Surveillance Report for MMWR Week 3

The influenza (flu) activity level for Texas for the week ending January 19, 2008 is “widespread.” Widespread activity indicates that at least half of the regions in the state are experiencing an increase in influenza–like illness (ILI) and have recent culture–confirmed influenza.

Reports from Health Service Regions

Reports were received from all 11 Health Service Regions (HSRs) for week 3. All regions except HSR 11 reported an increase in flu activity from the previous week. For a map of Health Service Regions, please visit the following website:

Laboratory Results

During week 3, four hospital laboratories throughout Texas reported conducting a total of 630 influenza tests (antigen, culture, and PCR) to the National Respiratory and Enteric Virus Surveillance System (NREVSS) sponsored by the Centers for Disease Control and Prevention (CDC). One hundred and fifty–five antigen detection tests positive for influenza A/not subtyped and six antigen detection tests positive for influenza B were reported from Bell, Bexar, and Ellis counties. Five PCR tests positive for influenza A/not subtyped were reported from patients residing in Bell and Williamson counties. Additional PCR tests positive for influenza A/not subtyped and influenza B were reported from Tarrant County. The Air Force Institute for Operational Health (AFIOH) reported six cultures positive for influenza A/not subtyped from Texas Air Force bases in week 3. A total of 90 reports of culture–confirmed influenza were received from NREVSS, the Texas Department of State Health Services (DSHS) Laboratory, Scott and White Hospital Laboratory, Texas Children‘s Hospital Laboratory, AFIOH, and other sources for the following counties:

Influenza A/H1

Influenza A/H3

Influenza A/not subtyped

Influenza B

Bexar County (2)

Bexar County (5)

Bell County (10)

Brazos County

Dallas County

Collin County

Bexar County (2)

Harris County (3)

Travis County (2)

Kleberg County

Bosque County

Randall County

Victoria County

Starr County (2)

Brazos County (11)

Travis County

Val Verde County

Burleson County (4)

Fayette County

Grimes County

Harris County (24)

Madison County

McLennan County (6)

Milam County

Taylor County

Waller County

Wichita County (3)

Williamson County

Additional positive results from point-of-care rapid flu tests were reported by providers throughout the state (see Texas map below).

Seven (100%) of the seven viruses were characterized as A/Solomon Islands/3/2006, the influenza A/H1 component of the 2007–08 influenza vaccine for the Northern Hemisphere.

Influenza A/H3 [22]

Two (9%) of the 22 viruses were characterized as A/Wisconsin/67/2005-like, the influenza A/H3 component of the 2007–08 influenza vaccine for the Northern Hemisphere.

Twenty (91%) of the 22 viruses were characterized as A/Brisbane/10/2007–like. A/Brisbane/10/2007 is a recent antigenic variant which evolved from A/Wisconsin/67/2005–like.

Influenza B (B/Victoria/02/87 and B/Yamagata/16/88 lineages) [3]

Victoria lineage [0]

The influenza B component for the 2007–08 influenza vaccine is a B/Malaysia/2506/2004–like virus, belonging to the B/Victoria lineage. Yamagata lineage [3]

Three (100%) of the three viruses were identified as belonging to the B/Yamagata lineage of viruses.

These results are very similar to national antigenic characterization results. The national results may be found in the CDC weekly flu report at http://www.cdc.gov/flu/weekly/. It is too early in the season to tell how well circulating strains will match the vaccine strains, or which influenza viruses will predominate this season. The DSHS Laboratory sends a representative sample of influenza viruses to the CDC throughout the flu season.

Influenza–Associated Pediatric Mortality

No new influenza–associated pediatric deaths were reported in week 3. To date, Texas has reported two influenza–associated pediatric deaths in the 2007–08 influenza season.

School Closures and Institutional Outbreaks

One school closure due to increased influenza–like illness was reported in Hartley County in week 3. No institutional outbreaks were reported.

Sentinel Provider Surveillance Network

Sixty–eight sentinel providers reported data to the U.S. Influenza Sentinel Provider Surveillance System (SPSN) on patients with influenza-like illness (ILI) and total patients seen for any reason during week 3; of those, 52 (76.5%) providers reported seeing at least one patient with ILI. Of all patient visits during this week, 5.90% were due to ILI. The ILI baseline for the West South Central Region (Arkansas, Louisiana, Oklahoma, and Texas) of the United States is 4.3% for the 2007–2008 season. The baseline is the mean percentage of patient visits for ILI during non-influenza weeks for the previous three seasons plus two standard deviations.

Percentage of Influenza–Like Illness (ILI) Reported by Sentinel Providers in Texas as of (1/28/2008 1:09:46 PM)